REPUBLIC OF THE PHILIPPINES)

CITY OF BATANGAS )SS.

AFFIDAVIT OF LOSS

I, GERALDO A. DELA LUNA, JR, of legal age, Filipino, married and with
residence at Brgy. Sambal Ilaya, Lemery, Batangas, after having been duly sworn
to in accordance with law hereby depose and state that:

1. My father is the owner of a vessel named LOURDES under Engine Make

of Isuzu/119.31; Serial No. 6BD1-847913;

2. He had been issued a Certificate of Fishing Vessel Safety by the MARINA,

Batangas City;

3. I kept the said Certificate in the cabinet at home at Sambal Ilaya,

Lemery, Batangas;

4. I discovered that the aforesaid Certificate of Ownership and Certificate of

Philippine Registry were missing and must have been lost and
inadvertently misplaced;

5. That the said Certificate of Ownership and Certificate of Philippine

Registry are free from lien and encumbrances;

6. Despite diligent efforts to locate said Certificate of Ownership and

Certificate of Philippine Registry, the same could not be found and are
now irretrievably lost;

7. I am executing this Affidavit of Loss to attest the truth of the foregoing,

of the facts surrounding the loss and for whatever legal purpose it may
serve.

FURTHER AFFIANT SAYETH NAUGHT.

IN WITNESS WHEREOF, I have here unto affix my signature this 17 th day

of January 2019 at Batangas City.

GERALDO A. DELA LUNA, JR

Affiant

SUBSCRIBED AND SWORN to before me in the City of Batangas this 17 th

day of January 2019 personally appeared the Affiant who exhibited to me his
Passport with No. EC2161883

Doc. No. 243;

Page No. 50;
Book No. I;
Series of 2019.